Diaper dermatitis is believed to be caused by the prolonged contact of the skin with body waste. The exact component or components of urine and feces responsible for diaper dermatitis has not been identified. Factors which have been suspected of causing diaper dermatitis include ammonia, moisture, bacteria, urine pH, and Candida albicans. Because these various suspected factors have different properties and require different therapies, the most effective method of treating diaper dermatitis has been the application of a topical protective barrier agent between the skin and the body waste.
Common protective topically applied barrier agents and the ingredients they contain include the following: Caldesene.RTM. Powder (calcium undecylenate, 10%, fragrance, and talc) and Ointment (petrolatum, 53.9%, and zinc oxide, 15%); Desitin.RTM. Ointment (zinc oxide, 40%, and cod liver oil, vitamins A and D, in a petrolatum-lanolin base, Leeming Division of Pfizer, Inc.); Balmex.RTM. Baby Powder (Balsan.RTM., a specially purified balsam, Peru, zinc oxide, talc, starch, and calcium carbonate), Ointment (Balsan.RTM., vitamins A and D, zinc oxide and bismuth subnitrate in an ointment base containing silicone) and Lotion (Balsan.RTM., lanolin oil, a nonsensitizing, dewaxed moisturizing fraction and silicone).
Other lotions, creams and ointments used in the treatment of diaper dermatitis and the active ingredients they contain include the following; Baby Magic Baby Lotion (Mennan) benzalkonium chloride; Johnson's Baby Cream (Johnson & Johnson) 2% dimethicone and Lotion; Diaparene Peri-Anal Medicated Ointment (Glenbrook Labs) 0.1% methylbenzethonium chloride; Suave Baby Care Skin Lotion (Helene Curtis); and Methakote DiaperRash Cream (Syntex) protein hydrolysate composed of L-leucine, isoleucine, L-methionine, L-phenylalanine, L-tyrosine, DL-methionine, cysteine hydrochloride, benzethonium chloride and talc, U.S. Pat. No. 3,061,512.
In addition to protective barrier agents, baby wipes are also used in the treatment of diaper dermatitis. Baby wipes are premoistened, disposable towelettes used primarily during diaper changes for cleansing. The wipe is usually constructed of non-woven wood pulp (approximately 85%) and another fiber such as polyester bonded with a styrene butadiene rubber latex. Wipes are generally moistened with water (over 95%) and contain various combinations of humectants, emollients, surfactants, preservatives and scents.
Baby wipes currently available and ingredients they contain include the following: Baby Fresh (Scott); Johnson's Baby Wash Cloths (Johnson & Johnson); Wet Ones (Lehn and Fink Products Group, Division of Sterling Drug, Inc.) natural aloe, U.S. Pat. Nos. 4,017,002 and 4,337,876; Diaperene Baby Wash Cloths with Lanolin (Glenbrook Labs, Division of Sterling Drug) U.S. Pat. No. 4,017,002; Tender Wipes (Young's Drug Products) benzethonium chloride; and Chubs Thick Baby Wipes (Lehn and Fink Products Group, Division of Sterling Drug, Inc.) aloe, U.S. Pat. Nos. 4,017,002 and 4,337,876;
Various combinations of the following ingredients are used in baby wipe products: water, SD alcohol 40, benzyl alcohol, propylene glycol, aloe vera gel, PEG-60 lanolin, PEG-75 lanolin, PEG-85 lanolin, sodium nonoxynol-9 phosphate, sorbic acid, oleth-10, oleth-20, fragrance, citric acid, disodium phosphate, DH DM hydantoin, sodium phosphate, benzalkonium chloride, methylparaben, propylparaben, butylparaben, sodium hydroxide, octoxynol-9, simethicone, polysorbate-20, cocoamphocarboxyglycinate, methylchloroisothiazolinone, methylisothiazolinone, trisodium EDTA, Quaternium-15, lauramine oxide, mineral oil, glycerine, PEG-8 stearate, petrolatum, Quaternium-27 and 2-bromo-2-nitropropane-1,3-diol.
Treatment of diaper dermatitis usually requires the combination of wipes and a protective barrier agent. The wipes are used initially, for cleansing, and then a barrier agent is applied for skin protection. Baby wipes currently available do not leave after application substantive or wash-resistant residues to protect the skin. Barrier agents are generally greasy and unappealing and are not effective cleansing agents. In addition, the use of some barrier agents may actually promote excessive skin hydration which may result in increased skin friction thus aggravating diaper dermatitis.
TAKE OFF (Johnson & Johnson) is a wipe product which contains an emulsion composition formulated as a makeup remover but has no substantive or skin protective properties.
There is thus a need in the treatment of diaper dermatitis for a hybrid product which would effectively cleanse and also leave a substantive highly protective residue on the skin. It would also be desirable to be able to apply the hybrid product as a wipe. The product should cleanse and leave a protective residue which does not significantly reduce transepidermal moisture loss.